Hygroma on the finger - treatment with and without surgery

Hygroma on the finger is an unpleasant articular neoplasm in the form of a cystic tumor formed from the connective tissue of the ligaments and serous fluid. Pathology can develop in any part of the body, but most often the anomaly affects the tendons of the upper extremities.

The disease mainly affects young women aged 20 to 30 years. The prevalence of hygroma among elderly people and children is insignificant. It is imperative to treat the tumor, despite its benign nature. Letting pathology take its course increases the risk of its metastasis and becoming chronic.

Characteristics of the disease

Tendon ganglion is the second name for hygroma.
Conventionally, the anomaly is considered harmless, but capable of causing physical and psychological discomfort to the patient. The shape of the hygroma is spherical and at the initial stage it is small in size. However, as the tumor grows in diameter, it can reach very large dimensions. The volume of the ganglion capsules increases gradually, without causing any concern at first. If pain is felt during manual manipulation of the tubercle, for example, by pressing, this is a reason to immediately visit a doctor.

The tumor consists of an articular membrane filled with a clear protein liquid mixed with fibrin and mucus. The capsule is attached to nearby tissues and bone structures, which provides the tumor with reliable fixation at one point. To the touch, the hygroma is elastic, dense and very mobile, and when you press on its surface, you can even feel the small rice bodies inside it.

According to assumptions, the root cause of cyst formation is degeneration (metaplasia) of connective muscle, cartilage or bone tissue. The hygroma is located mainly in the tendon sheath and articular capsule.

Symptoms and manifestations

As a rule, in most cases, hygroma is a practically asymptomatic disease. It does not cause any particular inconvenience to patients other than aesthetic ones.

The disease begins with a slight swelling over the joint area. Its distinctive characteristic is its clear demarcation from surrounding tissues. The skin over the tumor can move freely. As a rule, hygromas are single, but sometimes several formations can appear on the same joint.

Hygroma can grow either very slowly, almost imperceptibly, or rapidly. It should be noted that when the tumor begins to increase in size, it inevitably causes compression of the tendons and nerve-blood bundles. In addition, the functioning of the joint is impaired.

Patients are often interested in whether hygroma provokes pain. As a rule, patients feel pain of varying intensity if the tumor is located near the nerves. The pain can be either constant, not too pronounced, or radiating. Sometimes discomfort can appear only after intense exercise. Also, sometimes the hygroma increases slightly after active movement and decreases in size at rest.

As for the skin over the formation, it can either remain unchanged or become rough. In some cases, peeling is observed and the skin becomes reddish.

Classification of hygroma

Depending on the location, number and type of fibrous capsules, the cyst can take the form of an anastomosis, valve or isolated formation:

Anastomosis. Small cavities formed at the point of contact between the cyst and tendons and allowing fluid to move freely.
Valve. A kind of organic barrier between the tumor and the articular membrane, preventing the penetration of synovial fluid into the cavity.
Separate structure. Absolute isolation of the cystic formation.

The number of capsules can vary from one to several. In this connection, hygroma is distinguished as single-chamber and multi-chamber. Such a cyst is visualized as multiple nodular formations, concentrated in a crowded manner or located at a short distance from each other in independent formations.

Reasons for development

The factors that provoke the development of tendon ganglion have not been fully established. Possible causes of fibrous formation include:

Hereditary predisposition;
Single or repeated joint injury;
Systematic load on the fingers;
Inflammatory processes in joints and tendons;
Suffered bruises, dislocations and sprains;
Sustained degradation of ligamentous cells;
The result of professional activity requiring intense load on the upper limbs;
Microtrauma of the articular membrane.

A hygroma can form under the influence of several factors at once and occur on any finger.

Symptoms of the disease

The intensity of the manifestations of the cyst depends on the stage of its development. At first, the tumor is so clinically featureless that the patient does not even notice it. But over time, as it grows, hygroma can become quite aggressive and cause a lot of unpleasant sensations. Typical signs of a tendon ganglion are:

Pain in the joint area when the fibrous seal is compressed;
Tumor growth to significant sizes - from 3 to 6 cm;
Thickening and roughness of the skin at the site of the cyst;
Redness of the epidermis during current inflammation;
Very rapid tumor growth - literally in 1-2 days;
The presence of a soft, elastic consistency;
Slight impairment of joint mobility due to the influence of a growing cyst on it;
Low-grade body temperature - from 37 to 38 C°.

In some cases, suppuration of the synovial fluid, severe weakness, aching joints and muscles, nausea accompanied by vomiting, biomotor paralysis, local edema and fainting may be observed, which indicates microbial damage to the cyst and the development of a septic process. This situation requires urgent medical attention.

How it manifests itself

The tumor is filled with synovial fluid - the same substance that is normally found inside the joint, which explains its watery structure.
Palpation of the hygroma does not cause pain: there are no nerve endings in the cyst, it is not inflamed by itself (however, it can be a concomitant disease with chronic joint diseases, as well as inflammation; in such cases, pain is quite possible).
Initially, the ball under the skin is quite small and sometimes not immediately noticeable, although if localized on the finger it becomes visible quite quickly due to the specific location. Hygroma begins to grow with uncontrolled loads on the joint, in some cases - on its own.

How dangerous is the disease?

Hygroma itself is harmless. However, if it is injured or improperly treated, various complications and the development of a local inflammatory process are possible. Among the likely consequences of ganglion:

Spontaneous opening of the cyst and leakage of serous fluid into adjacent soft tissues or out;
Pressing the tumor contents into the joint cavity;
Metastasis and formation of multiple factions of the ganglion;
Inflammation and suppuration at the location of the cyst - tenosynovitis, etc.

If you handle the tumor carelessly and neglectfully, the risk of infection is quite high. Therefore, when doing a manicure or working in the kitchen, you should eliminate the possibility of accidentally injuring the cyst and introducing infection into its cavity.

Complications

Although hygroma does not degenerate into a malignant tumor, this does not mean that it does not pose a danger to human health.

Possible complications of a finger tumor include:

Spontaneous opening of a hygroma during injury. In this case, the risk of infection of the wound and adjacent tissues increases.
Deterioration in the sensitivity of the affected finger due to the pressure of the hygroma on the nerve fibers.
The appearance of severe shooting pains in the fingers, which resemble the clinic of neuralgia.
Deterioration of the blood supply to the finger above the area where the hygroma is located. This will lead to thinning of the skin, destruction of the nail plate, and the appearance of pustular wounds.

The larger the size of the hygroma, the higher the likelihood of developing complications. Therefore, it is necessary to start treatment in the early stages of tumor formation.

Diagnostic methods

Determining hygroma is not difficult, since the formation always has characteristic clinical signs. However, in order to exclude diseases with similar symptoms, differential diagnosis is carried out using standard research methods:

Palpation of the site of the ganglion lesion and measurement of its parameters;
Taking a cyst puncture;
X-ray of the finger;
MRI;
Ultrasound of the growth;
General laboratory tests - urine, blood, glucose levels, biochemical analysis, tests for hepatitis and sexually transmitted diseases.

Treatment of hygroma

The choice of therapeutic method for treating the cyst is based on the clinical findings of the examination and the degree of complication of the disease. To treat hygroma on the finger, different techniques are used:

Conservative methods. They consist of the introduction of glucocorticosteroids into the cyst cavity, the use of non-steroidal anti-inflammatory drugs, antibiotics, antihistamines, corticosteroids, muscle relaxants and topical ointments.
Physiotherapy. Involves the use of mud and paraffin applications, electrophoresis, phonoresis and hydrocortisone, UV irradiation, heat and compression bandages, massage.
Surgical removal or burectomy. Indicated in advanced situations in the presence of severe pain during mechanical movement of the phalanx, rapid growth of the cyst and its proliferation, numbness and immobility of the finger. The operation is performed under local anesthesia and takes no more than 30-40 minutes.

Puncture or puncture. Provides for pumping out the liquid contents of the capsule and introducing the drug into the free cavity.
Laser evaporation. The principle of the technology is the same as for strip surgery, but using a laser instead of a scalpel.

Crushing, although a simple method, is not the most effective. Due to its obsolescence, this technology is practically not used.

During the course of treatment and the rehabilitation period, it is not recommended to put pressure on the sore finger in order to prevent re-accumulation of fluid and the formation of new cyst fractions. For this reason, when a hygroma is diagnosed, sick leave is long.

Removing hygroma from a child

As noted above, most often cysts are diagnosed in young people aged twenty to thirty years. However, sometimes hygromas are diagnosed in children. It should be noted that often the occurrence of a neoplasm at the ankle joint is provoked by activities in sports sections and dance clubs, during which children are injured or experience serious stress.

If a hygroma is suspected, the child is referred to an orthopedic surgeon, and X-rays and ultrasounds are performed. Based on the test results, the doctor decides whether a conservative or surgical method will be used.

A referral for removal is issued if the formation rapidly increases in size, the child experiences pain not only when moving, but also at rest, and complains of numbness of the limb and limited mobility. Hygroma is also removed if conservative treatment does not bring a positive result.

For children who have not yet reached the age of ten, the operation is performed under general anesthesia. If the child is already ten years old, the doctor focuses on individual indications and performs the intervention under either general or local anesthesia. The sequence of surgery to remove a cyst in a child is the same as in adults. When the tumor is removed, a tight bandage, orthosis or elastic splint is applied to limit the mobility of the injured limb.

The most gentle option for a small patient is to remove the hygroma using an endoscope or laser.

Disease prevention

Taking care of your limbs - avoiding overexertion and injury;
Uniform distribution of the load on the hands and elastic bandaging when performing physical work;
Treatment of concomitant and chronic diseases - bursitis, arthrosis;
Avoiding rubbing calluses;
Do not delay treatment of pathology if it appears;
Balanced diet and access to vitamins;
Periodic medical examination, especially if there is joint disease.

Surgical intervention

Laser treatment of wrist hygroma in Germany is the most acceptable method, but in some patients it is still necessary to undergo extensive surgery, which is determined individually. For certain structural features of the hand, treatment of the wrist should be performed using full-fledged surgery.

Surgical treatment of wrist hygroma in German clinics is carried out as follows:

the specialist makes an incision over the hygroma, the length of which depends on the size of the formation;
Having carefully separated the surrounding tissue, the doctor excises the cyst from the synovial membrane of the joint and places sutures on the exit hole;
Having checked that the joint cavity is closed hermetically, the doctor sutures the edges of the wound and applies a sterile bandage;
the wrist joint is fixed in a stationary state with a special orthopedic design.

During recovery, the patient must comply with the main condition - to limit the mobility of the joint as much as possible in order to create conditions favorable to healing. During the first two weeks, the fixation device should be worn constantly, and for the next 2-3 weeks it can be worn at night. The sutures after the operation are removed on the 7-8th day, but the patient does not have to stay close to the clinic all this time - the sutures can be removed by a surgeon at the clinic at the place of residence.

A team of highly qualified specialists at Deutsche Medizinische Union works to ensure that patients from Russia and the CIS countries can easily access the best medical institutions in Germany, Austria and Switzerland. Full organization of all stages of therapy on our part ensures you a comfortable passage of all diagnostic and treatment procedures.

We control all stages of therapy, discuss unclear points with you, provide an interpreter, accompany you throughout your stay in the clinics, and review invoices. Before returning home, if the need arises, we will help you purchase medications in high-quality foreign pharmacies and contact your doctor. Our team has taken into account all the points that may prevent you from getting the best experience from your trip for treatment abroad.